Rates of women who are opting for preventive mastectomies, such as Angeline Jolie, have increased by an estimated 50 percent in recent years, experts say. But many doctors are puzzled because the operation doesn't carry a 100 percent guarantee, it's major surgery -- and women have other options, from a once-a-day pill to careful monitoring.

When Michael Utley hears someone suggest that the so-called “lightning crouch” will keep them safe, he wants to scream — and sometimes does.

And when Russ Chapman talks to yet another person who thinks he’s obsessive or phobic for staying away from storms, he is compelled to set them straight.

“I tell everybody I can come up with: Don’t mess with it. It’s much more involved than you think,” he said.

For lightning strike survivors like Marshburn, Utley and Chapman, the only thing more difficult than healing from a bolt from the blue is coping with the misconceptions, myths and downright stupidity they say surround this force of nature.

It’s a challenge that exists year-round, but it grows worse between June and August, the prime thunderstorm season, when as many as 50,000 lightning strikes an hour can bombard the U.S. on a summer afternoon.

Lightning kills as many as 70 people in the United States each year and injures more than 500, according to estimates from the National Weather Service. Already this year, 24 people have died, including eight in July alone.

While the annual total has dropped dramatically from a half-century ago, when lightning killed some 375 people a year — mostly farmers perched on metal machinery — it’s still too high in an era of wider awareness, improved prevention and better medical care, said John Jensenius, warning coordinator meteorologist with the National Weather Service.

“I think there’s a long way to go,” Jensenius said.

Lightning strike odds: 1 in 700,000
The trouble is that too few people take thunder and lightning seriously, he noted. The fabled long odds of getting struck by lightning — 1 in 700,000 in a given year — lull many people into complacency and prompt them to take chances, said Jensenius.

They play one more hole of golf, or go for a hike or a run despite a gathering storm. They’ll dash across a parking lot in an cloudburst or linger in a boat on a lake a little too long.

“Lightning safety is an inconvenience,” Jensenius said. “People are balancing convenience with safety. To be honest about it, the people who are struck err too much on the side of convenience.”

Michael Utley, 57, never thought about lightning safety before he was struck on a Cape Cod golf course in May 2000. The former stockbroker spent 38 days in an intensive care unit, more than two months in rehabilitation and still hasn’t recovered fully from the mental and physical effects of the ordeal.

“I am 70 to 80 percent of what I was,” said Utley, who now spends his time educating others about the issue through his Web site. “Lightning leaves little black spots on the brain. It fries the brain and body.”

To be sure, there are plenty of people more fascinated than fearful of the phenomenon. On a Facebook page dedicated to lightning storms, more than 271,000 fans swap stories and photos that extol the virtues of “nature’s amazing power.”

But those who study lightning injuries — and those who’ve survived them — say whether it’s distant thunder or a flash overhead, lightning storms should inspire respect — and fast action.

Taking shelter under a tree, relying on postures such as squatting low and balancing on the balls of the feet or simply failing to head indoors at the first rumble of thunder all invite death or injuries.

“If you’re out and there isn’t a safe place, there isn’t a safe place,” said Jensenius. “We just recommend running as fast you can.”

Only about 10 percent of lightning victims die; the remaining 90 percent suffer injuries that can range from mild shocks to permanent problems that include chronic pain, hypersensitivity, memory lapses and impaired thinking and concentration skills, said Dr. Mary Ann Cooper, a professor at the University of Illinois at Chicago, who is regarded as the leading international expert on lightning injury.

Nerve damage is the primary culprit because lightning disrupts the functioning of the long nerve cells, leaving many patients looking normal, but feeling and acting fundamentally altered, she said.

“A lot of your routine, where did you put your keys, how did you file this, the multitasking stuff, pieces are missing out of it,” Cooper said. “Their friends don’t come around anymore. The (lightning victims) don’t understand jokes, they’re socially inappropriate. All of those filters are kind of gone.”

Video: Teen recounts lightning strike
That's certainly been the case for Russ Chapman, 40, who was walking across a Littleton, Colo., parking lot in 1999 when lightning struck nearby and “splashed” over him, knocking him to the pavement and leaving him with lingering problems.

In the decade since the incident, he lost jobs because he forgot to go to work, he neglected to eat, suffered from ongoing severe headaches and sleep problems. He developed epilepsy, suffering one seizure while driving. He admits he's pretty leery of lightning now, refusing to go out in storms, for instance.

"I know for a fact that people think I'm really weird," Chapman said.

25 million lightning strikes a year
Lightning is created by the electrical discharge of the positive and negative regions of a thunderstorm, a separation of charge that produces enormous electrical potential within a cloud and between the cloud and the ground. Each flash carries and average of 300 million volts and currents ranging up to 20,000 amps, though extreme lightning can reach a billion volts, more than 200,000 amps and more than 54,000 degrees Fahrenheit, according to NASA’s lightning research team.

Nearly 25 million cloud-to-ground strikes occur in the United States each year, according to the National Lightning Detection Network, with Florida topping the list with more than 1.4 million flashes a year and about 25.3 flashes per square mile. By contrast, Washington state is at the bottom of the list, with less than 20,000 flashes per year and about .3 flashes per square mile.

But Steve Marshburn Sr. knows that all it takes is one strike to dramatically alter a life. He was a 25-year-old bank clerk in North Carolina in 1969 when lightning traveled through an ungrounded speaker and struck him. Now 64, Marshburn has endured 39 surgeries and three bouts of cancer. Along the way, he formed the group Lightning Strike and Electrical Shock Survivors International Inc. to provide information and support to survivors who often feel desperate and misunderstood.

“We’ve talked 20 people out of suicide on the phone so far,” Marshburn said.

Courtesy Of Michael Utley

Michael Utley was struck by lightning in 2000 on a golf course. He's shown here in 2003 with his wife, Tamara, and daughter, Sonia Catrina. Though lightning victims may look normal, their injuries can be profound and long-lasting.

The group was a lifesaver in the early years after he was hurt, said Utley. About 60 people are expected at the annual gathering next month in Myrtle Beach, S.C. That's down from the 150 who have attended in previous years. Worldwide about 1,600 people count themselves as members, Marshburn said.

Those who come to the meeting are often relieved to find others who understand the emotional fallout of an injury that leaves many victims impatient and argumentative, sometimes interfering with family life.

Given the lingering effects, lightning strike survivors are the strongest advocates for safety awareness, said Joan Greenfield, a Farmington Hills, Mich., psychologist who counsels victims of lightning strike and electrical shock. She understands their urgency because she was badly shocked in 1996 when she waded into ankle-deep water in a flooded basement and touched an ungrounded General Electric refrigerator.

“We’ve been fried and it affects us,” she said.

‘Everyone's called ‘Sparky’’Shock survivors are often frustrated by a medical community that fails to understand their injuries and needs and by a wider society where lightning strike is not taken seriously, or it’s an actual joke.